Weed Be Better Together: CBD Use After SCI

Marijuana. Weed. Pot. Ganja. Mary Jane. Devil’s Lettuce.

All these names describe one plant—the Cannabis plant. Although this drug is made up of hundreds of different compounds, the two most studied are tetrahydrocannabinol (THC) and cannabidiol (CBD). Both THC and CBD come from a family of compounds called cannabinoids. THC is the main psychoactive component that can cause the feeling of a high after marijuana use. CBD, on the other hand, does not produce a high and may have some therapeutic properties that alter the way individuals feel pain and help with relaxation.

It is essential to recognize that the reason CBD has an impact on the human body is because we have a naturally existing cannabinoid system. The human body can produce its own cannabinoid compounds, often referred to as endocannabinoids, and has receptors throughout that these endocannabinoids can bind to. These receptors can also bind to externally introduced cannabinoids like CBD, which is why marijuana has an effect on the human body. Our innate cannabinoid system plays a crucial role in the development and homeostasis of the central nervous system and is involved in pain pathways. In fact, there are some theories suggesting that what is commonly called a “runner’s high” may be due to endocannabinoids rather than endorphins, because cannabinoids can enter the central nervous system whereas endorphins cannot.

For individuals living with SCI, CBD use is often anecdotally cited to help improve pain, spasticity, and mental health, among other reasons. Of these reasons, research on SCI-related pain is perhaps the most well-studied—although still very limited. Several SCI animal model studies have reported that CBD plays a role in reducing pain. In other non-SCI-specific animal research, there is more literature describing the effects of CBD on managing and reducing neuropathic pain and the suspected mechanisms that may play a role. Unfortunately, clinical research in this area remains inconclusive, as some studies have found that individuals experience similar pain relief from CBD as they do from a placebo.

Fewer studies explore the role of CBD in improving spasticity in individuals with spinal cord injury. In one double-blind, placebo-controlled trial, participants with SCI and multiple sclerosis-related neuropathic pain and/or spasticity received oral capsules of either THC (up to 22.5 mg/day), CBD (up to 45 mg/day), a CBD & THC combination, or placebo over six weeks. This study found no difference in spasticity between three treatment groups—CBD alone, THC alone, and CBD & THC together. Other non-SCI-specific studies on spasticity have shown reductions in MS-related spasticity after an oral spray containing both CBD and THC was administered. Another study testing the same oral spray found that this treatment may be beneficial for MS patients whose spasticity was otherwise resistant to common anti-spasticity medications. While it is unclear whether the same effects can be achieved in a spinal cord injury patient population due to the lack of robust research in this area, it indicates the need for further research in this area.

Other studies done on CBD as a therapeutic have shown in rat models that it can help reduce anxiety. Interestingly, one study also explored the role of CBD in bone mineral loss, a common phenomenon that occurs in individuals with spinal cord injury. In this rodent study, the CBD treatment reduced the loss of bone mineral below the level of injury. The authors of this study proposed that CBD may achieve this by promoting bone formation and inhibiting bone resorption through the modulation of specific protein signaling pathways.

While marijuana has exciting potential to help individuals with spinal cord injury, it would be remiss to not mention marijuana in the context of society. As of April 2025, medical marijuana use is legal in 38 states, the District of Columbia, and several U.S. territories, and recreational marijuana use is legal in 24 states, the District of Columbia, and several U.S. territories. Before considering marijuana use, it is critical to understand the laws in your state. Additionally, given that there are several strains of marijuana and many CBD and THC products available on the market, consulting a physician about marijuana use is strongly recommended to ensure safety and efficacy.

Overall, cannabinoids, given the mixed results from CBD-related research, more research is needed to understand their full potential and risks. As interest and access grows, staying informed and speaking with healthcare providers is key to making safe, effective choices.